1. Field of the Invention
This invention relates to a new suturing technique and in one aspect to an improved surgical drape combined with the suturing member such that the sutures will be in approximate position adjacent the marginal edges of the skin prior to its being incised to be in position upon completion of surgery to rematch the sides of the wound.
2. Description of the Prior Art
Sutures have been used for holding surgical wounds together and retention sutures hold the wound together under tension and are usually made of nylon and penetrate the skin at positions spaced widely from the wound. Closure sutures are sewn to the skin margin to bring the marginal edges of the skin into approximation to heal. Outside surface sutures are taken out after the wound has had a chance to mend while buried sutures are used on different layers of the skin tissue and are positioned under the skin. All of these types of sutures penetrated the interior tissue of the body.
Advances in suturing has led to the use of staples which were used to draw the skin together and avoid damage to the inner tissue to the extent caused by placement of the plastic closure sutures. Further advancement led to the pressure-sensitive adhesive tape closures or steristrips and the butterfly sutures which are adhesive strips placed across the wound. These sutures avoided any damage to the interior tissue but were put in place after the operation. Thus, it was necessary to try to rematch the skin on the opposite sides of the wound, which, is not easy if one is trying to proximate, i.e. match the opposed tissue.
Thus, there are disadvantages with all the prior techniques for repairing the surgical wound. Some of these disadvantages are the fact that the inner tissue is damaged due simply to the suturing. The suturing may be handled in such a manner that a foreign body or germ may be injected into the wound or the suture material may serve as a wick. Invasive sutures are also painful. If the skin is moist, tape sutures will not stick well, and it is necessary to utilize some aid to adhesion such as tincture of benzoin as an aid. In the event of an infection in a surgical wound, it is often necessary to remove the sutures such that the wound may be reopened. When closed subsequently, invasive sutures again cause further tissue damage and pain.
The present invention overcomes the disadvantages afforded by prior art suturing techniques. First of all, the skin closures of the present invention are applied prior to making the incision. This is advantageous in that the sutures are in place to proximate the edges of the wound prior to making the incision, and linear approximation is achieved prior to the opening of the skin such that it may be easily matched. The skin is treated for improved adhesion prior to the incision being made such that attempts to apply the suturing material will not be frustrated. The combination of the drape and skin closure or suture dressing affords the rapid closing of the incision after surgery and affords a means whereby the wound may be opened without removing the sutures in the event of some cause to do so. This avoids the necessity of further puncturing the skin to rebind the wound.
Additionally, the sutures may be readjusted for tension after the patient leaves the operating room, postoperatively at will. The sutures are noninvasive such as the steristrips and the butterfly sutures. There is no pain associated with the suturing and they are easily removed in any sequence desired, and need not be seriatim. Because the skin closures are incorporated into the larger drape and are adhered to a large area of the skin, they afford good tension sutures with less irritation to the skin surface due to the shear stress on the adhesive. This feature protects the skin from tears and the patient from discomfort because of the stress on small areas of the skin.